Latest news with #PDAB
Yahoo
20-05-2025
- Health
- Yahoo
PDAB weighs diabetes drug affordability, as Moore weighs bill to expand PDAB
Medication vials marked for calibration await counting at the Exchange Pharmacy at Joint Base Andrews, Md., July 27, 2023. (Photo by Staff Sgt. Jared Duhon/U.S. Air Force) A Maryland board tasked with bringing down prescription drug costs is working through a 'dossier' of a medication to treat type 2 diabetes — the first of many such reports to determine if there are ways for the state to save money on certain medications. The Prescription Drug Affordability Board unveiled a 92-page draft report Monday for Farxiga, a brand-name medication for dapagliflozin, to help board members determine if the drug is 'unaffordable' for Marylanders. It is the first of several dossiers analyzing the cost burdens of six popular prescription drugs in an effort to find avenues for the state to save on medications for those on the state's health plan. PDAB staff have been working on the Farxiga dossier since November, according to Andrew York, executive director for the board. He hopes that future dossiers will be easier to pull together now that staff have a format to work with. Six drugs were selected for 'cost review,' and address several conditions including Type 2 diabetes, heart disease, kidney disease, eczema, Crohn's disease and more. Dupixent Farxiga Jardiance Ozempic Skyrizi Trulicity 'I think staff now knows the time it takes to put these dossiers together,' York told the board during the virtual Monday meeting. 'That organizational process and cross referencing to make sure that everything is available to the board — that took a lot of time and effort. But now that that template's in place, I think we'll be moving forward pretty quickly.' Since the board's inception in 2019, it has been involved in a lengthy rule-making process to determine what drugs could be expensive for state employees and to establish methods to bring those costs down. In March 2024, PDAB board members officially selected six drugs to undergo the 'cost review' process, part of which includes an information gathering period to develop a dossier on the drugs. But the board has yet to bring down costs for any drugs on the state health plan. Meanwhile, Gov. Wes Moore (D) is expected to sign off on legislation Tuesday to expand the authority of the board to bring down costs for more Marylanders, not just those on the state plan. Critics in the legislature and the pharmaceutical industry cited the pace of the board's progress to argue unsuccessfully against expanding PDAB's authority, but House and Senate bills to do just that passed by comfortable margins this year. House Bill 424 and Senate Bill 357 would allow the board to establish what are called upper payment limits on the commercial market, to place a limit on how much the state is willing to pay for certain drugs. The board currently has that authority for state employees and others on the state health plan. The expanded authority would only go into effect a year after the board has successfully placed upper payment limits for two drugs on state health plans – meaning it will still be some time before the state can wield its new authority on the commercial market. But the dossier Monday sheds some light on different considerations that the board will use to determine if it will take action to reduce state spending on Farxiga — including overall state spending on the drug, prevalence of the diseases that the prescription drug treats, and costs of the disease to the health care system. In Maryland, about 10.5% of adults aged 18 years or older had been diagnosed with diabetes as of 2022 data, the report says. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX 'In Maryland, for calendar year 2021, total and per-patient medical costs attributable to diabetes were $6.506 billion and $11,909, respectively,' the report says, citing data from the American Diabetes Association. The dossier reports similar data for other conditions Farxiga is often prescribed to treat, such as heart failure and Chronic Kidney Disease. From 2022 through 2023, Maryland spent $1.4 million on the most common dosage of Farxiga (10 MG) for those on the state health plan – about 289 Marylanders, according to the dossier. The dossier reports that out-of-pocket costs for Farxiga can vary, depending on insurance coverage. The median cost for 10 milligrams of Farxiga cost $160 for those with commercial insurance in 2023, but those on the state health plan paid $60 for the same dose. Meanwhile, those on Medicare paid a median of $158.90, according to 2022 data. But portions of the report are redacted from the public due to confidentiality restrictions, and the dossier is not finalized yet. Following Monday's meeting, PDAB staff will make tweaks on the dossier to more clearly relay the information. The Farxiga dossier will then go up for a 15-day public comment period. Staff is working on a dossier for another drug that helps treat type 2 diabetes called Jardiance, which should also be available for public comment soon, according to York. The board still has to officially determine if Farxiga or Jardiance pose an 'affordability challenge' before board members can consider next steps to bring down costs, which could include setting upper payment limits. Savings for the state health plans still appear to be a ways off.
Yahoo
15-05-2025
- Health
- Yahoo
Why we can't afford to lose the Prescription Drug Affordability Board
"In just one year, the PDAB identified $6 million in potential savings for our state." (Getty Images) When 1 in 4 New Hampshire residents are rationing or skipping their prescription medications due to cost, we need to strengthen our efforts to make life-saving prescriptions more affordable — not weaken them. Yet that's exactly what some lawmakers are attempting to do by dismantling our strongest defense against skyrocketing prescription prices. The New Hampshire Legislature's budget proposal, which has passed the House of Representatives and is currently being considered by the Senate, would completely defund the Prescription Drug Affordability Board (PDAB), our state's only independent, nonpartisan entity dedicated to addressing the rising costs of life-saving prescriptions that so many Granite Staters rely on. The statistics around prescription prices are both alarming and personal. More than half of our residents (53%) are worried about affording their prescription medications, regardless of if they make less than $50,000 a year or more than $100,000 a year. Additionally, 80% believe that drug companies charge too much money. These aren't just statistics; they represent real Granite Staters struggling to choose between filling a necessary prescription and paying for groceries or rent. The burden is particularly heavy on our older residents, who are expected to comprise nearly 30% of our population in the next 10 years. A 2024 New Hampshire survey found that 93% of adults aged 65 and older took at least one prescription medication regularly, with nearly one-third taking four or more. The same survey found that nearly 40% of people in New Hampshire have cut back in some way (food, fuel, electricity, etc.) due to the cost of prescription medications. Skipping critical medications isn't just a financial decision — it's a potentially life-threatening risk that can worsen chronic conditions and lead to costly emergency interventions. New Hampshire's PDAB, established in 2020, is rooted in our state's values, like taking care of our own. The PDAB works for Granite State residents and taxpayers — not for drug companies, middlemen, or insurers. Since its inception, the PDAB has brought much-needed transparency and accountability to the complex world of drug pricing, which has long operated in the shadows. It is working to identify ways to reduce the massive amounts our state spends on medications through public insurance programs and state employee benefit plans. For example, the PDAB has identified that the state is struggling with the same high-cost prescription drugs now negotiated by Medicare. As more high-cost drugs are negotiated for lower prices, the PDAB could make recommendations about how to leverage price negotiations at the federal level to achieve similar savings in New Hampshire. In just one year, the PDAB identified $6 million in potential savings for our state. Currently, they are exploring a partnership with a discount card program that could save the state an average of $212 per prescription while protecting patient data and supporting independent pharmacies. Further, the PDAB identified that the state could realize savings by allowing pharmacies to substitute FDA-approved biosimilar biologic drugs; this measure was included in the House budget as a cost savings. These are tangible, meaningful interventions that directly impact our people and our communities. Now is not the time to dismantle our PDAB. There is simply no other organization that can step in to provide the same level of oversight and insight into this critical area of our health care system. The PDAB has identified millions of dollars in savings, which far outweigh the PDAB's budget. To abandon the PDAB at this juncture is penny wise and pound foolish. The PDAB is our only defense against rising prescription costs. Stand with the 53% of residents who worry about medication costs. Stand with the 80% who recognize that drug companies are charging too much. Stand with the only strategy currently available to control prescription drug costs in our state.
Yahoo
09-04-2025
- Politics
- Yahoo
A tale of two governors
Ceremonial pens staged for the first of five bill signings after the 2025 session of the General Assembly. (Photo by Bryan P. Sears/Maryland Matters) When Gov. Wes Moore adds his expected signature to landmark prescription drug affordability legislation passed by the General Assembly, it will highlight how his values on this life-saving issue are in stark contrast to those of his predecessor, Larry Hogan. From the beginning of his tenure, Moore worked to empower Maryland's first-in-the-nation Prescription Drug Affordability Board (PDAB). By contrast, Hogan undermined and hindered the PDAB's work. In 2019, the Maryland General Assembly, led by Del. Joseline Peña-Melnyk (D-Prince George's and Anne Arundel), now chair of the House Health and Government Operations Committee, passed legislation creating the PDAB. Hogan neither signed nor vetoed it, letting it become law without his signature. But the next year, when the General Assembly passed legislation to fund the PDAB, Hogan vetoed it. Although the General Assembly overrode this veto the following year, Hogan's callous action delayed its work. Further, Hogan slow-walked key appointments to the PDAB and its Stakeholder Council, which also hurt the PDAB's ability to operate. Maryland Matters welcomes guest commentary submissions at editor@ We suggest a 750-word limit and reserve the right to edit or reject submissions. We do not accept columns that are endorsements of candidates, and no longer accept submissions from elected officials or political candidates. Opinion pieces must be signed by at least one individual using their real name. We do not accept columns signed by an organization. Commentary writers must include a short bio and a photo for their bylines. Views of writers are their own. Under the original 2019 law, the PDAB was supposed to set up a process for making high-cost drugs more affordable for the state government and local governments by the end of 2022; the General Assembly would then decide in 2023 whether to authorize the PDAB to help all Marylanders afford their drugs. But, because of Hogan's roadblocks, the PDAB could not meet this timeline and, therefore, the General Assembly did not act to expand the board's authority that year. Then Moore came to the rescue. In his inaugural address, he said it was a priority to ensure all Marylanders have quality, affordable health care. He knows that this cannot be done without making high-cost prescription drugs more affordable. Many Marylanders have trouble affording life-saving drugs, forced to choose between purchasing their medications or paying for other necessities of life. But additionally, high drug costs affect all of us, as we are forced to pay higher health insurance premiums. The large drug corporations argue they need to charge these outrageous prices, which are much higher than anywhere else in the world, to fund research. But the truth is that big Pharma spends far more on advertising and profits than on research. In 2023, working with the General Assembly, Moore allocated a critical $1 million for the PDAB, which helped jump-start its work after Hogan's veto had stalled it. The governor knew the state would recoup that money many times over from saving money on high-cost drugs. The governor and General Assembly also passed new legislation confirming the PDAB's authority to help state and local governments afford their drugs. This board's hard work and support from Gov. Moore are starting to pay off. Under the leadership of Chair Van Mitchell and Executive Director Andrew York, the PDAB is poised this year to make high-cost drugs more affordable for the state government and local governments, saving Maryland taxpayers millions of dollars. Based on this, and with the support of the Moore administration, the General Assembly, led by Dels. Bonnie Cullison (D-Montgomery) and Jennifer White Holland (D-Baltimore Coutny) and Sens. Dawn Gile (D-Anne Arundel) and Brian Feldman (D-Montgomery), just passed legislation expanding the authority of the PDAB so it can help all Marylanders afford their high-cost drugs. The governor has pledged to sign this measure into law. Wes Moore is not the only governor with the courage to stand up to the drug corporations. Following Maryland's lead, Govs. Jared Polis of Colorado, Tim Walz of Minnesota and Jay Inslee of Washington signed strong PDAB laws in their states. Unfortunately, one governor, Glenn Youngkin of Virginia, outdid Larry Hogan by actually vetoing a PDAB bill. We are very proud of the progress we are making in Maryland under Gov. Moore to make high-cost drugs more affordable. This is critical because drugs don't work if people can't afford them. We encourage other governors around the country to follow Governor Moore's example.
Yahoo
21-03-2025
- Health
- Yahoo
Why the PDAB bill deserves Gov. Youngkin's veto
(Photo by) As a father, I am deeply concerned about my daughter Angelica's future if Virginia enacts HB 1724, a bill that would create a Prescription Drug Affordability Board to set limits on the costs of certain medications. Angelica has Prader-Willi Syndrome (PWS), a rare genetic disorder that impacts her growth, hunger, and overall development. Managing her condition requires access to specialized medications, including growth hormone — the only approved treatment for PWS. If Virginia's Prescription Drug Affordability Board (PDAB) sets upper payment limits on newer therapies, it could make it harder for families like mine to access life-changing treatments, creating barriers to care rather than improving affordability. My wife and I were thrilled to be expecting after three years of marriage. Early genetic testing at 20 weeks revealed that our daughter had PWS, a devastating diagnosis. At birth, she had low muscle tone, couldn't eat on her own and barely cried. After 21 days in the NICU, she came home requiring constant monitoring. She has since been diagnosed with Autism and Scoliosis and relies on daily therapies to progress. Despite her challenges, my daughter has made remarkable strides. She can now walk, run, jump, kick a ball, talk and eat independently. However, she still struggles with routine changes and is beginning to show an increased interest in food — a potential sign of hyperphagia, the relentless hunger that is the hallmark of PWS. Without access to growth hormone and other specialized medications, her quality of life and future independence could be in jeopardy. Another major concern with HB 1724 is the potential use of Quality-Adjusted Life Years (QALYs) in determining drug value. QALYs assign a numerical value to a person's life based on their health status, often disadvantageous to individuals with disabilities or chronic conditions by devaluing treatments that improve their quality of life rather than curing their condition. If the PDAB relies on QALYs to set upper payment limits, rare disease patients like my daughter could face significant barriers to accessing essential medications. History shows that PDABs fail to deliver on their promises. In 2019, Maryland passed a PDAB, yet it has not saved a single patient any money. If this model hasn't worked there, why would we expect it to work in Virginia? Instead of reducing costs, price controls create uncertainty in the drug supply and discourage innovation. HB 1724 does nothing to address the root causes of high drug prices and could leave some of the most vulnerable Virginians without the medications they need to survive. There are better solutions for Virginians. Instead of imposing price caps that could drive critical drugs out of Virginia, lawmakers should focus on policies that protect access to life-saving medications while also addressing affordability concerns. I urge Gov. Youngkin to once again veto the PDAB legislation. My daughter's life — and the lives of many others with rare diseases — depend on it. Virginia families should not have to worry about whether their loved ones will have access to the medications they need to thrive. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX
Yahoo
22-02-2025
- Health
- Yahoo
Tensions run high on PDAB expansion vote
Republican Minority Whip Jesse Pippy, right, and Minority Leader Jason Buckel rise with other GOP lawmakers Friday to challenge Majority Leader David Moon, left, after he criticized President Donald Trump and Elon Musk during floor debate. (Photo by Danielle J. Brown/Maryland Matters) Just days after pointed, but civil, debate on a proposal to expand efforts to control prescription drug costs, the House floor erupted in a partisan shouting match Friday that had to be gaveled back to order by an angry Speaker Adrienne Jones (D-Baltimore County). The uproar came during the final House vote on House Bill 424, a bill that would expand the authority of the Prescription Drug Affordability Board. That board was created in 2019 and charged with reducing the cost of prescription medicines purchased by state health plans. Even though it has made slow progress on that front, HB424 would give the board the power to rein in the cost of drugs purchased by any drug provider in the state. Republicans fought the bill all week, pointing to the lack of progress by PDAB on its current goals, saying the regulations would drive pharmaceutical companies out of the state and suggesting that expanding the board's authority could threaten the availability of drugs in Maryland. GOP lawmakers offered a string of unsuccessful amendments Wednesday that they said were aimed at potential unintended consequences of the bill, such as limiting access to prescription drugs and creating market disruptions. Supporters, like Del. Bonnie Cullison (D-Montgomery), the sponsor of the bill, argued that PDAB will not set price caps, as opponents claim, but would merely establish the the highest price the state — and under HB424, other purchasers — were willing to pay for a drug. It has the potential to lower drug costs for those who need it most, they said. The debates earlier this week, were calm — boring, even. That changed during Friday's debate. House set to approve expansion of drug board's authority to lower costs Republicans renewed many of their criticisms from earlier in the week, including arguments that expanding PDAB could limit access and threaten research and development of new drugs. Several took the opportunity to use HB424 as a proxy for health care regulation in general, and veered into long criticisms of the 2012 Affordable Care Act. Several Democratic lawmakers tried to steer the discussion — which took up more than 40 minutes of Friday's hourlong floor session — back to the bill at hand. By the time Majority Leader David Moon (D-Montgomery) stood to explain his vote, he had heard enough of what he called the 'Bizarro World floor debate' of the Republicans. 'The minority party is claiming to worry about research and development into lifesaving medications. They claim to care about access to health care. This bill is not your problem if those are concerns,' said Moon, who turned the debate into an argument over the rapid-fire cuts to federal agencies by President Donald Trump and tech billionaire Elon Musk, who is in charge of Trump's Department of Government Efficiency. Moon referenced recent layoffs at federal regulatory agencies such as National Institutes of Health and the Food and Drug Administration, which are housed in Maryland, and had been cited in some Republican amendments earlier in the week. 'President Musk, and what Vice President Trump are doing – that is your problem,' Moon said. His deliberate mischaracterization of Trump and Musk's dynamic first earned a few chuckles from Democrats, and then a chorus of 'boo's' from Republicans. ''Boo' — Yes, 'boo,'' Moon responded sarcastically. When Del. Lauren Arikan (R-Harford) stood up and interrupted Moon to explain her vote, Moon snapped, 'I'm not done.' That led Arikan to charge Moon had gone over the two-minute time limit to speak. She was joined by a half-dozen other Republicans demanding to make a point of order, to explain their votes or to argue that Moon had exceeded his time, until Jones stepped in to quiet the cacophony of voices. 'I've not recognized anyone else,' Jones shouted over disruption, bringing the gavel down hard three times to stop the frenzy. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX 'Let me speak,' Jones demanded. 'His [Moon's] time is up, he's going to sit down.' Moon agreed and sat. She then told everyone to sit back down and 'relax – if you can.' Jones then recognized Arikan, who called the exchange 'painful.' 'I don't know what this bill could possibly have to do with Donald Trump or Elon Musk. This bill is about rigging the market. Conservatives never like that. I am so sorry to offend you with our belief that the free market is the best way to lower the cost of things.' Other than a few snarky remarks about the flare-up itself, the debate went on without any other disruptions and HB424 ultimately passed on a party-line vote, 94-38. It now heads to the Senate, where a companion bill has yet to get a committee hearing. Following the floor session, Moon defended his floor remarks. 'It's just very strange to me, given the totality of everything going on in the world, to be having a conversation about pharmaceutical research and development,' he said, 'specifically talking about the NIH and the FDA in floor debate on Republican amendments, supposedly to improve access to health care and lower prescription drugs — and specifically foster research and development 'The thing that's actually threatening what they claim to care about … is all of the announcements that we've heard from the federal government this week — gutting mass layoffs and the likes at those very agencies,' Moon said. 'It's just a wildly disconnected conversation.' The final word Friday went to Del. Stephanie Smith (D-Baltimore City), the majority parliamentarian, who gently reminded House members of the rules of floor debate and the need to keep things cordial — reminders that are becoming a semiregular occurrence. 'Just a couple of refreshers — we only speak when we are acknowledged by the Speaker to do so. Also, when we are rising to explain our vote … the clerks are timing,' she said. 'Also, the Speaker is the keeper of order and quorum in the House. It has been the custom of this chamber to not be overtly political or personal in this chamber. 'That's for everyone in the chamber, no matter what side of the aisle you are on,' she said to a smattering of applause. 'We all have to abide by those rules.'
